In our hospital, nipple shields are available to the nurses, who sometimes
hand them out.  This was driving me crazy when I first started here, and
resulted in one of my young moms being stuck with a nipple shield for the
duration of her breastfeeding experience.  She weaned at 4 months, at least
partly out of frustration at always having to use the shield.
So now, for my own patients, nipple shields must be okayed by me, and I
never okay them without a consult from our IBCLC.  I also have an order on
the newborn's chart that I must okay any formula supplement.

Jennifer Tieman
Family Physician
Mom to 3, and new baby #4 expected 5/31/03

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